Friday, August 25, 2006

A terrible Plan: The morning-after pill will be sold over the counter. There are many reasons to reverse that decision.

BY:
Mary Worthington

Plan B... emergency contraception... the "morning-after pill." Phrases such as these have been much in the news lately as the Food and Drug Administration and Barr Pharmaceuticals battle over whether to make this drug available over the counter (OTC). Yesterday, that battle came to an end when the FDA approved Plan B for over-the-counter sale to women 18 and older. Girls 17 and younger will still need a prescription.

This bad move, we're told, is being made "in the name of women's health." That's appalling, especially when the facts are considered. If we really want to prevent women from being hurt, we should shove Plan B back behind the counter.

Plan B consists of two pills taken 12 hours apart within three to five days of sexual intercourse. The dosage of contraceptive drug in these pills is 12 to 15 times that of a regular contraceptive pill. Remember: Plan B is now cleared to be sold OTC, yet the lower-dose conventional Pill still requires a prescription. Odd. Never before has a higher dose of a particular drug been made available OTC while a lower-dose preparation still requires a prescription. And that could lead to potentially risky situations. Women who cannot obtain a prescripton for the Pill because of health concerns such as high blood pressure may now have access to Plan B and may assume it is safe for use.

Unlike with a prescription, the person purchasing Plan B over the counter may not necessarily be the one taking it. Whatever guidance the pharmacist might give with the sale may never reach the woman who plans to take the drug. Because purchasing the drug will now be easier, anyone from a parent to a sexual predator could purchase Plan B for a minor, possibly putting her health at risk (scientific studies have not established the degree to which Plan B is safe for teens) as well as increasing chances for sexual abuse.

Plan B makers and advocates purport that the drug is to be used only in emergency situations - defining emergency very loosely. In promotional information and on its Web site (http://www.go2planb.com/ForConsumers/Index.aspx), Barr Pharmaceuticals, maker of Plan B, says the drug is intended for use "after known or suspected contraceptive failure or unprotected intercourse." Many purchasers will disregard the term emergency and use the drug as they themselves see fit.

With easy access to Plan B, some women might take the drug several times a month. That seems most likely with teens (who could get older people to buy it for them) and college-age women. If complications arise, these might go untreated or be seen merely as side effects. Without immediate physician supervision at the time they take the pills, girls and women risk side effects, drug interactions, and overdosing. Indeed, the maker and promoters warn against the latter.

There are also statistics and studies to be considered. In Scotland, the morning-after pill has been available OTC since the early 1990s. True, we can make no simplistic post hoc correlations here between access to a drug and wholesale sexual behavior, but it's at least worth considering that since OTC morning-after pills have been available in Scotland, rates of sexually transmitted disease (STD) have skyrocketed as well as the number of abortions. A 2004 British study found an increase in STDs and no decrease in the number of abortions after easy access to Plan B among teens. A January 2005 study in the Journal of the American Medical Association showed that after easy access to Plan B, abortion rates did not decrease.

These and other studies suggest that easy access to Plan B is not an effective way to decrease the rate either of sexually transmitted diseases or of abortions. The FDA has made a mistake in according over-the-counter status to Plan B. Here's hoping the policy is revised or ended soon.

Contact Mary Worthington at mworthington@generationlife.org.
Mary Worthington is a staff member of the nonprofit group Generation Life.